Insurance - Medical in Portland

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Helpful Definition for: Insurance - Medical

Medical insurance, in Portland,provides insuranceagainst the medical expenses, incurred unexpectedly. An insurer develops a routine finance strategy to ensure the availability of money for medical needs mentioned in the insurance agreement, after estimating the overall risk involved.

A medical insurance in Portland is basically a periodically renewable contract between the insurance company & the client or his sponsor. The insured individual possesses a number of obligations to such an insurance policy, such as-

The amount to be paid by the client after a regular interval to buy the health coverage, called the premium, the amount to be paid by the insured before the insurer pays its share, called the deductible, the amount to be paid when the insurer pays for a service, called co-payment, the percentage of the total cost for a service to be paid by the client, called co-insurance.

This type of insurance do not cover all the medical services availed by the client; the services that are not covered by the insurance are called exclusions. The medical insurance policies generally provide assistance only up to a pre-decided limit, called coverage limit. Once the payments made by a client reaches out-of-pocket maximum, he medical insurance pays all further covered costs, exempting the insured from his obligations. A health care provider agrees to treat all members of an insurer once he is paid the Capitation money.

The medical insurer provides a certification, called prior authorization before the client receives a medical service, ensuring payment for that service.

Public Medical Insurance & Private Medical Insurance are the two major categories of this service.